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[缺陷:定义观察到的症状的主要或次要特征的价值与困难]

[Deficit: the value and difficulty of defining the primary or secondary character of observed symptoms].

作者信息

Petit M, Langlois S

机构信息

Groupe de recherche sur la schizophrénie, Université de Rouen, Centre Hospitalier du Rouvray, Sotteville-lès-Rouen.

出版信息

Encephale. 1996 Jun;22 Spec No 2:13-8.

PMID:8767036
Abstract

Since early descriptions of schizophrenia, heterogeneousness of clinical forms is one of the most typical figure of the disease. Nowadays authors perceived the necessity for patients to gather in groups in the most homogeneous way. First, different clinical effects have been noticed among schizophrenic patients with neuroleptics in function of their type or their dose. Then dichotomic concepts between positive and negative forms of schizophrenia succeeded one another. Several scales for negative symptoms of schizophrenia have been used to test the antideficit effect of different doses of neuroleptic agents. But these punctual evaluations cannot confirm primary nature of these symptoms, not derived from positive, depressive, anxious symptoms or secondary symptoms of neuroleptic treatment (as akinesia). Carpenter et al. defined the concept of deficit syndrome in schizophrenia, which can be evaluated with the SDS (Schedule for the Deficit Syndrome, Kirkpatrick et al., 1989). This classification of patients showed certain particularities: clinical, neurologic and biological ones, which seemed to confirm the initial hypothesis of homogeneousness of deficit syndrome in schizophrenia. The relevance of this concept forecasts a very promising future to research in the area of schizophrenia, with therapeutic and evolutive implications.

摘要

自从对精神分裂症有了早期描述以来,临床症状的异质性就是该疾病最典型的特征之一。如今,作者们意识到有必要以最同质化的方式将患者分组。首先,人们注意到,使用抗精神病药物的精神分裂症患者会因药物类型或剂量的不同而产生不同的临床效果。接着,精神分裂症阳性和阴性形式之间的二分法概念相继出现。人们使用了几种评估精神分裂症阴性症状的量表来测试不同剂量抗精神病药物的抗缺陷效果。但这些即时评估无法证实这些症状的原发性,它们并非源自阳性、抑郁、焦虑症状或抗精神病药物治疗的继发性症状(如运动不能)。卡彭特等人定义了精神分裂症缺陷综合征的概念,该概念可用SDS(缺陷综合征量表,柯克帕特里克等人,1989年)进行评估。对患者的这种分类显示出某些特殊性:临床、神经学和生物学方面的特殊性,这似乎证实了精神分裂症缺陷综合征同质性的最初假设。这一概念的相关性预示着精神分裂症研究领域有着非常广阔的前景,并具有治疗和演变方面的意义。

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